Over-the-counter drugs could affect driving

Posted: Wednesday, January 19, 2000

By Deb RiechmannAssociated Press

WASHINGTON -- Prescription painkillers and over-the-counter cold pills can cause drowsiness in even the safest drivers. To help save lives, federal safety officials want new tests done to find out what role these drugs play in fatal truck, train, bus and boat wrecks.

Pilots killed in plane crashes already are routinely tested for commonly prescribed drugs and drugstore remedies. Now, the National Transportation Safety Board wants similar testing done for other means of travel. And the board wants the Transportation Department to produce a list of pills people can safely pop when operating large trucks on the freeways, freight and passenger trains, boats and buses traveling in and out of town.

''Since 1987, the safety board has investigated over 100 accidents in all modes of passenger transportation that involved prescription or over-the-counter medications whose effects could potentially impair the vehicle's operator,'' the NTSB said in issuing its safety recommendation.

In aviation, prescription and over-the-counter drugs contributed to 84 of 4,840 -- about 2 percent -- fatal plane accidents that occurred between 1987 and 1996, the board said. More than 120 people died in these plane accidents.

One on Feb. 4, 1995, involved a Cessna 150 that crashed into a tree near Arnaudville, La., slid into water and sank. The safety board cited the pilot's use of Valium, a tranquilizer and muscle relaxant, as a factor in the crash that killed the pilot and injured a passenger.

The safety board's recommendation does not include automobiles. But the National Highway Traffic Safety Administration estimates that 100,000 crashes -- 3 to 4 percent of motor vehicle accidents -- occur each year as a result of drivers falling asleep behind the wheel. While not directly linked to prescription or over-the-counter drugs, NHTSA says the accidents, which involve motorcycles to 18-wheelers, cause 76,000 injuries and 1,500 deaths each year.

A spokesman for the Transportation Department said agencies that regulate trucks, buses, trains and boats, are reviewing the recommendation.

''The department is concerned about the potential side effects of prescription and nonprescription medications used in transportation operations,'' the spokesman said.

He said the department has initiated informational campaigns on the problem and already does extensive tests for illicit drugs.

Investigators of most surface transportation accidents gather information on vehicle operators' use of five classes of drugs -- marijuana, cocaine, opiates, amphetamines and phencyclidine, or PCP -- identified in Transportation Department regulations. The Federal Railway Administration also tests for barbiturates and benzodiazepines, which includes Valium.

But little data is collected on the role prescription drugs, such as antidepressants and anti-anxiety medications, and over-the-counter drugs, including antihistamines, play in these accidents. This prompted the board to recommend that the Transportation Department establish requirements for doing toxicological tests on a representative sample of operators involved in fatal highway, railroad, bus and marine accidents.

The NTSB's safety recommendation also asks the Food and Drug Administration to develop easy-to-recognize warnings for prescription or over-the-counter drugs that can specifically interfere with a person's ability to drive. In Sweden, such drugs are labeled with a warning triangle, the board said, and pharmacists in Australia often voluntarily affix a red triangle even though it's not required under the law.

In March, FDA regulations took effect requiring consumer-friendly labels that provide instructions in large print and highlight proper dosages and safety warnings. The FDA will review the NTSB recommendation as it works on future labeling policies, spokeswoman Susan Cruzan said.

The FDA already includes warnings about operating vehicles in labeling it approves for new prescription drugs, she said. ''It's up to the pharmacist to provide the information to the consumer,'' she said.